Good hygiene practices, such as hand-antisepsis and wearing of protective garments, are necessary to maintain safety, and it is useful to have an automatic system that will assist persons to perform such personal hygiene tasks. Healthcare associated infections (HAI) lead to greater than a billion dollars in excess healthcare costs annually, which is occurring within an economic environment that is charged with improving patient safety and quality while reducing healthcare costs. Further, pursuant to Deficit Reduction Act (DRA) of 2005 §5001 (c), the Secretary of Health & Human Services to identify, and reduce payments for, conditions that are: (a) high cost or high volume or both, (b) result in the assignment of a case to a DRG that has a higher payment when present as a secondary diagnosis, and (c) could reasonably have been prevented through the application of evidence-based guidelines. HAIs, thus, exert both a human and economic toll.
Despite recognition of the problem and prior implementation of various hygiene education and disinfection programs, HAI rates remain unacceptably high. Moreover, HAI creates a dilemma for health-care management, because of the worldwide problem of evolving, multi-drug resistant bacteria and the increasing complexity of the healthcare environment. However, the prevailing view is that many HAIs are preventable complications, a view highlighted by the Centers for Medicaid and Medicare Services (CMS) decision that preventable complications, such as vascular-catheter-associated infections, will no longer be reimbursed by Medicare. Other infections may follow.
The etiology of HAIs in health-care settings is explained at least in part by bacterial cross contamination, which is generally believed to be a consequence of poor compliance with best hand hygiene practices. Multimodal intervention strategies have been shown to be more effective than single intervention approaches, but more effective ways must be found to implement such strategies.
It is well known that disease and infection is often transferred from one person to another as a consequence of poor hand hygiene practices by one or more persons in a chain of transmission. The issue is most pronounced in the healthcare industry, including hospitals, care homes and hospices, where visitors and caregivers, including nurses, doctors and therapists, should cleanse their hands regularly. This is especially critical when the persons are moving between treating different patients. Indeed, even patients should be encouraged to be hygienic whenever they exit their room. But the problem is not limited to healthcare institutions. Possibilities for transmitting germs from one person to another are also significant in the hospitality industry where employees have contact with food, service ware, bedding and the public. Schools, day care centers and offices have similar issues. Other environments may also require regular hand hygiene. The environments where good hygienic practices are desirable and should be encouraged are generically referred here as “institutions,” and the term includes healthcare facilities such as hospitals, care homes and hospices; facilities involving food handling, such as agricultural facilities, food-processing facilities, catering facilities and restaurants; hospitality facilities, such as hotels and motels; and childcare facilities such as day care centers and schools. All persons within an institution are users of the facility and should be encouraged to maintain good hygienic practices, and, thus, the term “users” is intended to cover all persons within an institution, whether they are employees, third-party contractors, visitors, patients, students or have other reasons for being within an institution.
Healthcare-associated infections (HAIs) are defined as infections not present and without evidence of incubation at the time of admission to a healthcare setting. Within hours after admission, a patient's flora begins to acquire characteristics of the surrounding bacterial pool. It is estimated that in the U.S. alone, there are over 2,000,000 HAIs each year. They conservatively cost $17 billion dollars to resolve and result in 100,000 deaths per year, and nearly one third of these are attributable to poor hand hygiene. Thus, HAIs extract a very high price from society in terms of human pain and suffering as well as treatment and legal costs. Surveillance, along with sound infection control programs, not only lead to decreased healthcare associated infections but also better prioritization of resources and efforts to improving medical care, and programs in health-care institutions to control healthcare-associated infections have been in place since the 1950s. Nevertheless, it is believed that a far more significant portion of these HAIs can be prevented if health care providers practice proper hand hygiene. Indeed, the Centers for Disease Control recognizes that improved hand hygiene compliance with standards for infection control practice is a key to substantially reducing healthcare-associated infections.
Infectious microbes that can be acquired or transmitted in a healthcare setting include: Acinetobacter baumannii, Burkholderia cepacia, chickenpox (varicella), C DIFF (Clostridium difficile), Clostridium sordellii, Creutzfeldt-Jakob Disease (CJD), ebola virus (viral Hemorrhagic Fever), hepatitis viruses A and B, influenzaviruses, MRSA (methicillin-resistant Staphylococcus aureus), mumps, norovirus, streptococcal species, Pseudomonas Aeruginosa, parvovirus, poliovirus, pneumonia, rubella, SARS, S. pneumonia, tuberculosis, VISA (vancomycin intermediate Staphylococcus aureus), and VRE (vancomycin-resistant enterococci). MRSA is a type of staph bacteria that is resistant to certain antibiotics called beta-lactams. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin, and amoxicillin. The more severe or potentially life-threatening MRSA infections occur most frequently among patients in healthcare settings. Reducing MRSA in healthcare and other institutions had become a high priority, and recent data indicates that MRSA can be controlled to at least some extent by proper hygienic policies. In 2010, a CDC study showed that invasive (life-threatening) MRSA infections in healthcare settings declined 28% from 2005 through 2008. In addition, the study showed a 17% drop in invasive MRSA infections that were diagnosed before hospital admissions (community onset) in people with recent exposures to healthcare settings.
However, practicing proper hygiene is a difficult task. The failure of workers to employ good hand hygiene practices results from a confluence of factors including lack of knowledge of standards, apathy, time pressures, resistance to change, and perceived inconvenient location of hand disinfection dispensing apparatuses for hand hygiene. Proper hygiene requires following strict rules that demand frequent antisepsis. The major challenge faced by caregivers is that the use of these agents in the quantities and the frequencies necessary to adhere to commonly accepted hand hygiene guidelines results in dangerous and painful degradation of the skin on the users' hands. Resistant strains of pathogens such as MRSA and C DIFF particularly now dictate the use of the harsh rubs and soaps. Following their use, caregivers are encouraged to utilize a secondary skin conditioning agent immediately thereafter to protect their skin from damage.
It must be recognized that not only patient sites, but non-patient sites also are proven sources for hand contamination, including computer keyboards, cell phones, and fixed telephones. New systems and methods designed to encourage, effect, monitor and enforce hand sanitation and other hygienic practices are needed to reduce the spread of infectious microbes in institutions. While the healthcare industry is primarily addressed here, the problems and resultant solutions presented are applicable to a range of industries and service organizations.
Effective implementation of dispensers for soaps, sanitizers and other liquids is useful in the implementation of an overall hand-wash compliance system. Many institutions and industries have provided numerous disposable or refillable (reusable) dispensing containers of sanitizer and/or soap to facilitate individuals in their efforts to sanitize and/or wash their hands. And while the availability of such dispensing containers has increased the opportunities for individuals to wash and/or sanitize their hands, there is still a lack of complete compliance with predetermined hand washing hygiene standards. However, to minimize the potential transmission of bacteria and/or viruses by hand washing and sanitization, full compliance with hygiene standards is required, as the failure of individuals to properly clean and/or sanitize their hands can negate the efforts of others who come in contact with such individuals. Dispensers intended for use in hand-wash compliance systems are known. These include:
U.S. Pat. No. 7,315,245 discloses a method and apparatus involving a soap dispenser base where pressure exerted on a soap dispenser in contact with the soap dispenser base activates a timing means coupled with the base which gives information to the soap dispenser user on the correct duration of time to wash their hands. The base may also include a signal means that the soap dispenser has in fact been utilized. Additionally, the soap dispenser base product may also contain marking mechanisms which are designed to be placed on a variety of different styles of soap dispensers. The marking mechanisms contain an easily identifiable substance which can only be removed by effective hand washing.
U.S. Pat. No. 6,707,873 discloses a device which measures individual employee usage of a liquid product or hand soap dispenser as part of an overall hygiene compliance program. The dispenser consists of a self-contained keypad/display module which is attached to a standard hand soap dispenser. An employee enters a unique personal ID code and then activates the dispenser. The dispenser counts all inputs to the dispenser in order to generate meaningful data for management. Alternatively, the dispenser may only track and report total usage and not account for individual employee usage.
U.S. Pat. No. 6,542,568 discloses a system for rewarding and encouraging compliance with a predetermined personal hygiene standard in a hygiene compliance program. The system comprises a fluid dispenser. The fluid dispenser includes an actuator. A sensor is connected to the actuator. A processor in electrical communication with the sensor. The processor is configured to increment a count when the sensor is actuated, relate the count to the identification code, and compare the count to a predetermined number.
United States Patent Application Publication No. 2013/0099900 discloses an actuation sensor apparatus configured to removably attach to a liquid dispenser, the apparatus comprising (a) an electronic circuit including a dispense sensor and a wireless transmitter and (b) a power supply for the electronic circuit, whereby, when dispenser actuation occurs, an identification code unique to the apparatus is wirelessly transmitted to a receiver. In a preferred embodiment, the dispense sensor is a magnetic sensor and the apparatus further includes an actuator arm having a magnet, and the actuator arm is configured to move with respect to the magnetic sensor during actuation.
United States Patent Application Publication No. 2013/0076514 discloses a hygiene compliance monitor for a dispensing container that dispenses material when a dispensing nozzle is actuated, includes a flexible main section having a receiving aperture through which the dispensing nozzle extends, so as to enable the main section to be removably attached to the dispensing container. Extending from the main section is a secondary section that is terminated by an attachment sleeve that is configured to removably retain the dispensing nozzle therein. A token, such as a magnet, is carried by the attachment sleeve and is detected by a sensor carried by the main section. Thus, when the dispensing nozzle is actuated to dispense material, the sensor detects the presence and non-presence of the token and accordingly updates a count value that is presented on a display that represents the number of actuations of the dispensing nozzle.
United States Patent Application Publication No. 2013/0122807 is directed to a networked system and method for improving hygiene practices which includes an interactive communication system of user devices and an information engine. Wired and wireless data transmission methods are provided. The networked system and method is incorporated by reference where indicated below with respect to communication between several mechanisms in the hygiene-monitoring system.
United States Patent Application Publication No. 2013/0094983 is directed to a refill unit for a foam dispenser including a liquid container and a diaphragm foam pump connected to the liquid container and diaphragm foam pumps. The diaphragm foam pump includes an elastomeric diaphragm having an air piston bore and a bellows. The air piston bore forms at least a portion of an air chamber. A reservoir is located at least partially within the bellows that includes a liquid inlet. The diaphragm foam pump includes a piston that forms a portion of the air chamber wherein the piston bore may be moved relative to the piston. Movement in a first direction causes air in an air chamber to be compressed and draws liquid into the reservoir and further movement in the same direction causes compressed air to flow into the reservoir where it mixes with the liquid and is expelled as a foam.
United States Patent Application Publication No. 2013/0079923 is directed to a sheet product dispenser includes a housing having a front cover, a main controller, a motor, a dispensing mechanism, a maintenance switch, and an auxiliary feed push button. The motor, main controller and dispensing mechanism are configured to dispense a length of sheet product in response to a signal representative of a request for sheet product.
Unfortunately, current dispensers used in hygiene compliance monitoring systems are not sufficiently helpful in promoting good compliance.
The World Health Organization (WHO) launched a Global Patient Safety Challenge in 2005 and introduced the “5 Moments Of Hand Hygiene” in 2009 in an attempt to reduce the burden of health care associated infections. This model of hand hygiene prompts health care workers to clean their hands at five distinct stages of caring for the patient. The five events are:                before touching a patient,        before clean/aseptic procedures,        after body fluid exposure/risk,        after touching a patient,        after touching patient surroundings.        
It is an object of this disclosure to provide apparatus to further hand-wash compliance.
A further object of this disclosure is to provide a dispensing apparatus which may be adapted to assist persons in meeting hand-wash compliance requirements.
These and other objects of this disclosure will be apparent from the following descriptions and from the drawings.